McRae Prostate Cancer Awareness Foundation

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

L4401 Issued in AL

Legal business name

MCRAE PROSTATE CANCER AWARENESS FOUNDATION

Practice address

503 W MLK Hwy
Tuskegee, AL 36083-2142

Phone

(334) 226-1177

Fax

(334) 226-1108

NPI assigned

Dec 10, 2011

Last updated

Dec 10, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Lawrence W McRae Sr.

Title

Executive Director

Phone

(334) 226-1177

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1323475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323475200000",
    "number": "1144598772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 W MLK HWY",
            "city": "TUSKEGEE",
            "state": "AL",
            "postal_code": "360832142",
            "telephone_number": "334-226-1177",
            "fax_number": "334-226-1108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 W MLK HWY",
            "city": "TUSKEGEE",
            "state": "AL",
            "postal_code": "360832142",
            "telephone_number": "334-226-1177",
            "fax_number": "334-226-1108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCRAE PROSTATE CANCER AWARENESS FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-10",
        "last_updated": "2011-12-10",
        "status": "A",
        "authorized_official_last_name": "MCRAE",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "334-226-1177",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "AL",
            "license": "L4401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Royal Bettis Maxwell
• Cecilia McCary, CRNP
• Marashia McCormick, LGSW
• Madason McCurdy, LMSW
• Jerry Lavell McDonald, RPSGT, RST
• Jothanie McRae, CRNP
• Andrea Lynn Menyhert, PH.D.
• Sylvia Minger
• Carolyn M Moffet, RD
• Montgomery Vamc

• Clinical Medical Laboratory in Tuskegee, AL
• Providers in Tuskegee, AL by specialty
• Clinical Medical Laboratory in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.